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EAC CONVERSION > Asthma > Flashcards

Asthma Flashcards

1
Q

Describe the pathohysiology of asthma. 6

A

Airways almost continuously sensitive or inflamed. Trigger causes bronchospasm. Inflammation increases and mucous secreted. Bronchial muscles. Hyperinflation. Reduction in tidal volume.

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2
Q

What are the 8 triggers that may exacerbate asthma

A

Pollen. Cigarette smoke. Dust mites. Pets. Mould. Exercise. Stress. Sudden temp changes

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3
Q

What are the 5 clinical features of moderate asthma?

A

Can speak in full sentences. Spo2 >=92. Peak flow >=50% best or predicated. HR less than or equal to 140 ages 2-5. HR less than or equal to 130 in 5+. RR less than or equal to 40 in 2-5 yrs. less than or equal to 30 in 5+

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4
Q

What are the 5 clinical features of acute severe asthma attack

A

Can’t complete sentences in one breath or too breathless to talk or feed. SPO2 >140 ages 2-5 >125 ages 5+. RR >40 ages 2-5. HR >30 age 5+.

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5
Q

List the 8 clinical signs of life threatening asthma attack

A

Cyanosis. Confusion. Silent chest. Hypotension. Exhaustion. Spo2 below 92. PEFR below 33% of best or predicted. Poor resp effort.

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6
Q

How many inhalers used in a year is a red flag?

A

Over 12

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7
Q

List 5 risk factors of near fatal asthma (medical)

A

Previous near fatal asthma. Previous hosp admission from asthma especially in last year requiring 3 or more classes of asthma meds. Heavy use of beta2 agonist. Repeated ED attendance for asthma care especially in last year. Brittle asthma.

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8
Q

List 15 physiological/behavioural risk factors for near fatal asthma

A

Non compliance with treatment/monitoring. Failure to attend appointments. Fewer GP contacts. Frequent home visits. Self discharge from hosp. Psychiatric illness or self harm. Current or recent major tranquilliser use. Denial. Alcohol or drug abuse. Obesity. Learning difficulties. Employment problems. Social isolation. Childhood abuse. Severe domestic marital or legal stress

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9
Q

How would you manage moderate asthma attack? 4

A

Move to calm quiet environment. Encourage use of own inhaler 2 puffs every 2 minutes up to a max of 10. High%o2 therapy. Consider nebuliser salb.

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10
Q

How would you manage acute/severe asthma attack. 2

A

Consider ipatropium bromide nebuliser. Continue with salb neb unless clinically significant side effects occur.

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11
Q

How would you manage life threatening asthma 1

A

Consider administering adrenaline

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12
Q

How would you manage near fatal asthma 1

A

Consider positive pressure ventilations using BVM and T peice

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13
Q

What four obs must you remember before and after asthma treatment?

A

HR. RR. PEFR. Etco2 and spo2

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14
Q

What are the therapeutic effects of using salbutamol.

A

Reverses bronchospasm and is a selective beta2 adrenoreceptor stimulant

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15
Q

What are the indications for salb use 4

A

Acute asthma attack. Expiratory wheeze. Exacerbation of COPD. SOB due to LVF

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16
Q

What are the contraindications of salb use?

A

None

17
Q

What are the cautions for using salb? 5

A

HTN+. Angina. Overactive thyroid. late pregnancy. Beta-blockers.

18
Q

What are the five side-effects for using salbutamol

A

Tremor. Tachycardia. Palpitations. Headache. Feeling of tension. Peripheral vasodilation

19
Q

What is the Administration and dosage for six years plus using salbutamol

A

5 mg nebulised

20
Q

What is the administration and dosage for ages less than or equal to 5 years

A

2.5 mg nebulised. Always cross check pocketbook the dosage and routes

21
Q

What are the therapeutic effects for using Ipatropium bromide

A

Antimuscarinic bronchodilator

22
Q

What are the three indications for use of Atrovent

A

Acute severe or life-threatening asthma. Acute asthma unresponsive to salbutamol. Exacerbation of COPD unresponsive to salbutamol

23
Q

What are the contra indications for using Atrovent

A

None

24
Q

What are the three cautions for using Atrovent

A

Glaucoma. Pregnancy and breastfeeding. Prostatic hyperplasia

25
Q

What are the seven side-effects for using Atrovent

A

Headache. Nausea and vomiting. Dry mouth. Difficulty in passing urine and or constipation. Tachycardia/arrhythmia. Paroxysmal tightness of chest. Allergic reaction

26
Q

What is the administration and dosage for using Ipratropium bromide. 3

A

Adult >12 500mcg. 18months -

27
Q

How many nebulisations can you give Atrovent

A

Once only

28
Q

After how many doses of salbutamol would you administer I Pratropium bromide

A

Concurrent with first dose of salbutamol in severe or life-threatening asthma. Or concurrent with second or later dose of salbutamol and unresponsive COPD or asthma

29
Q

When would you do a time critical transfer for asthma

A

In life-threatening or acute severe asthma

30
Q

What are the two therapeutic effects of adrenaline 1:1000

A

Sympathomimetic that stimulates both alpha and beta receptors. Release bronchospasm in acute severe asthma

31
Q

What is the indication for using adrenaline 1:1000

A

Life-threatening asthma with failing ventilation and continue deterioration despite nebulisation therapy

32
Q

What is a contra indication of using adrenaline

A

Repeated doses in hypothermic patients

33
Q

What are the cautions of using adrenaline2

A

Beta-blockers. Tricyclic antidepressants

34
Q

What are the side effects of using adrenaline

A

None

35
Q

What is the administration and dosage of adrenaline 1 in 1000. 4

A

Adult 500mcg IM. Child 6-11 300mcg. 0-5 years 150mcg. Repeat after 5mins if clinically indicated. Always cross check pocket book for dosesge and routes

36
Q

State the 6 aietiologys of asthma

A

Inherited. Modern lifestyles. Smoking during pregnancy. Environmental pollution. Viral infections. Irritants found in workplace

EAC CONVERSION (9 decks)

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